Wednesday, July 30, 2008

Shooting Up

No, not like THAT. Tonight's shot night. I know I mentioned in another post that I have health issues. Well, to be specific, I have A health issue: rheumatoid arthritis (RA). I was diagnosed one month short of two years ago. It's almost my anniversary lol. RA is an autoimmune disorder in which the immune system goes a bit nuts and attacks the joints and the tissues around the joints, primarily. No known cause, no known cure. Lol, my body sure can pick 'em huh? My causal theory is genetic predisposition (which come to find out there is...waaay back in my family tree) triggered by some sort of physical stress (for me, losing 60 lbs in 3 mths MIGHT have done the trick...silly emotional turmoil affecting the physical!) If left untreated, RA can progress to a system-wide chronic inflammatory disorder. Lucky for me, I'm getting great treatments! Two of which are injectable in form: Enbrel and methotrexate. The combination of these wonderful drugs is what has me in remission.

Enbrel is what they call a biologic: it targets a specific response of my immune system and shuts it down. Which means it's easier for me to catch colds and stuff, supposedly. I haven't had any issue with it yet (knock on wood), but I try to be careful anyway. Methotrexate is actually a drug they use in chemotherapy with cancer patients. I take a much MUCH lower dose than that, but the drug is the same.

To be clear, remission in RA does not mean the disease goes away...just that it is successfully managed so as to cause the least amount of pain/discomfort. My joints are still stiff for 5-10 minutes in the morning, and my elbows will never be the same...especially the right one, which doesn't straighten all the way anymore. Good thing I'm tall...I can still reach things on high shelves! Lol. My ankles and my knees don't do very well with high impact...walking's ok, but for exercise I use a stationary bike: absolute lowest impact of any cardio machine I've found yet! All in all, there are so many diseases that could be and are a load worse than the one I've got. Yes, it's still a pain in the ass, and yes sometimes it still frustrates the hell out of me when I can't do something I used to be able to do...but the other day I opened a new jar of jelly all by myself, and the week before that, a new jar of pickles! When at one point I couldn't even pull socks on my feet because it hurt both my feet and my hands/wrists too badly, every accomplishment is an accomplishment, no matter how small, and no matter how long I've been in remission. At least, that's what I have to keep reminding myself when I start getting truly frustrated and, yes, occasionally depressed about the whole thing. But that doesn't happen as often as it did! I'm slowly coming to terms with my new limits...but that doesn't mean I'm giving in! I still push the envelope, so to speak, and sometimes that works out fine, and other times I have a flare.

A flare means the remission is over, temporarily. Then I do whatever I can to undo the reason for the flair--take it easy for a day, relieve some stress, cut salt waaay down in my diet, use heat packs, whatever! Then the medicine kicks back in and does its job.

Which brings me back to the prompt for this blog. Tonight is shot night. I have a sure-click (think like an epi-pen) of Enbrel, and a syringe and vial of methotrexate. The Enbrel I push a button and endure while it dispenses the medicine into my leg with a highly painful burning sensation. Four deep, slow breaths, and generally it's over. Then I get to measure out the methotrexate into the syringe and inject it into my leg. I HATE that part. I will never understand how people can shoot up for recreational drug use...the action of sticking a needle into your own flesh is sooo counterintuitive that even now, after almost a full year of this medication, I still take AT LEAST 5 counts of 1-2-3 to inject. Gah. My stomach's always in knots for the hour that I let the Enbrel reach room temp (it has to be kept refrigerated), not because I'm afraid of the shots, but because I know they're going to hurt and there's not a damn thing I can do. Then comes the day or two of low-level nausea and bone-deep weariness. I attribute the nausea to the methotrexate, and the weariness to the Enbrel...but I can't tell for sure. I take them both on the same night, at the recommendation of my rheumatologist, to get it all over with on the same day. The positive thing is when we decide to have a kid I have to go off all of my medication...which means any nausea then could be a pregnancy sign! Lol. Oh, and RA goes into remission during pregnancy, though it often comes back worse after the baby's born...but that's ok...we're gonna risk it at least once!

Anyway, all of that said, these drugs truly are wonderful. Within 2 months of starting Enbrel (almost a year and a half ago) I could walk normally, put on my socks and shoes by myself, and handle buttons with ease! After 3 months on the methotrexate (it took a bit longer to kick in) I was just about up to the level of remission I'm in now! Which is to say, the disease is still there, but I can function pretty much normally. Granted, I'll never be able to work out like I did in high school again--with my elbows, lifting weights is problematic and I'll be hard-pressed to ever do a push-up again, and my knees and ankles pretty much rule out bleachers and even regular running. But that won't keep me from living my life to the fullest, getting back in shape (I am DETERMINED!!! lol), and being the best me I can be! As corny as that last sounds, I am determined to find out what that means, on all levels--because that, friends, is self-knowledge.

Throughout this whole process, my family has been supersupportive and loving. However, noone has done quite as much for me as my husband. He was the one to help me put on socks and shoes the holiday season after I got diagnosed. He pushes me when I'm giving in too easily--physically and emotionally--and holds me when I've done all I can, and when it all gets to be just that much too much. He has helped me see all the ways in which I can still be useful, helped me find my new definition of useful, and just basically has been so all-around wonderful with all of this that I don't know how I would have gotten through it without him. I'd have gotten through, but the journey would have been much more hellish. I sure do love that man! :-)

On that uplifting and positive note, it's time for me to go "shoot up". I realize this post was not quite in the same vein as my other just thinking posts, but it's what was on my mind tonight. Nor should this blog be read as a definitive definition or description of RA...that's why I included the link to the Arthritis Center's Disease Center RA page ;-). This is just what was running through my mind tonight.

Anyways, I was just thinking.


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